Thursday, March 20, 2008

Is GINA a good thing?

The DNA blogosphere has been sporadically abuzz with chatter about the Genetic Information Nondiscrimination Act (GINA), which appears to be almost universally regarded as a good thing. In fact, a Nature editorial last week proclaimed that "the entire scientific and medical community is adamantly supportive of this bill" and implied that a failure to pass the GINA would have had disastrous consequences for the field of genetics as a whole:

Otherwise, the enormous research and clinical progress being made in the nascent era of personalized medicine will come crashing to a halt because people — despite the efforts of George Church — will remain rightly wary of taking genetic tests.

A letter to Nature this week from Spanish scientist and Biopolitical blogger

I, for one, do not support this bill.

Better information allows better matching of people and jobs, and of people and insurance policies. The purpose of firms is to produce goods and services efficiently, and information helps to improve efficiency. The purpose of insurance is to manage risk, and information availability lowers risk.

You fear that the use of genetic information by employers and insurers will lead to social inequality — or, in other words, you trust that ignorance will preserve equity and fairness. There are better ways to deal with social inequality than to force ignorance upon workers, employers and insurers. And a better informed, more efficient, wealthier society creates better conditions for everyone to live decent and productive lives, whatever our genetic make-up.

I'm not necessarily supporting this view - although I'm certainly not as unambiguously positive about GINA as others appear to be - but rather throwing it out there for discussion.

Discussion:
The OpenHelix blog makes some excellent points.



Subscribe to Genetic Future.

5 comments:

Misha said...

First off, long-overdue kudos on your blog, which is a welcome addition to the conversation.

Second, I'm not sure anyone is advocating ignorance per se, any more than my group health plan, which pools my risk along with the thousands of others enrollees. GINA is merely posing the question: how do we want to treat the most vulnerable among us? What kind of society do we want to be? (Okay, so that's 2 questions)

mem from somerville said...

I don't know why my previous comments vanished, but I will add this:

You. have. no. understanding. of. our. current insurance. system.

I don't want to hear arguments from anyone who has basic health care available from the government.

We. do. not.
Period.

If you have a genetic condition--or even suspicion of one--you can be DENIED health insurance in this country.

Do you understand what that means?

Daniel said...

Hi guys,

Misha: good points. I can certainly see the deeper questions in play here; I just need to know more before I'm convinced that GINA is the best way to address these questions, or if it may end up actually being counter-productive.

Mem: Certainly, the basic healthcare safety net provided by the Australian government makes this discussion somewhat more academic for me, although I'm not sure if it should bar me from participating in the discussion!

You don't really make an argument in favour of GINA, but rather an argument against the current healthcare system in the US. I can only point to Fuentes' statement that "There are better ways to deal with social inequality than to force ignorance upon workers, employers and insurers." I wonder if you and Fuentes would both agree that GINA is a band-aid solution, and that there are much deeper underlying issues that will ultimately need to be resolved one way or another - although you may well differ on the ways in which those issues should be resolved.

mem from somerville said...

Yes, the posts that vanished provided links to the Congressional testimony about the young girl denied health insurance because her mother was a carrier of a genetic condition--yet the daughter was unaffected.

It has nothing to do with social inequality and workers. 8-year olds are denied insurance coverage. Now. Today.

People are fired from their jobs because their conditions might be too costly. Today.

This is not academic and theoretical for us.

Are you aware that uninsured medical issues are the main cause of bankruptcy in the US? How's that for creating a second class of citizens?

Search for Sharon Terry's Congressional testimony. It can be found on the Genetic Alliance site. It contains the letter from the little girl who can't get health insurance.

I completely disagree with everything Fuentes said about GINA and insurance. It was clueless and uninformed.

The argument for GINA is that we have discrimination today, and it needs to stop. People won't get tested for genetic conditions today because they fear insurers. This is dangerous--and cost-ineffective. Monitoring and prevention would cost less. But if you could lose your insurance, you won't do it. Research is being hindered that could lead to better understanding and treatment.

dd said...

It is worth noting that in the US, most people and elected representatives are for GINA. A single US Senator is blocking its passage in the Senate. This has real affects on people and research in the US. People are not getting tested and therefore not getting treated for treatable disorders. They are also not willing to consent to have their DNA sequenced for research purposes.